Active NPI
Robert Medeck, DC CCST
- Chiropractor
- Ashland, OR
National Provider Identifier
1013965029
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2147
- Practice address
- 1875 Hwy 99 N
Ste 11
Ashland, OR 97520 - Phone
- (541) 482-2225
- Fax
- (541) 488-2962
- NPI assigned
- May 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2147 | OR | Primary |
Addresses
Primary practice location
1875 Hwy 99 N
Ste 11
Ashland, OR 97520
Mailing address
1875 Highway 99 N
Ste 11
Ashland, OR 97520-9120
Phone (541) 482-2225
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 230721 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in OR
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060609000228 | OR | Practitioner - Chiropractic | 4183636186 | Practice locations: Ashland, OR |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 1985
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1875 Hwy 99 N
Suite 11
Ashland, OR 97520-9600
Phone (541) 482-2225
1875 Hwy 99 N 11
Ashland, OR 97520-9600
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146700800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1445299200000",
"number": "1013965029",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1875 HIGHWAY 99 N",
"address_2": "STE 11",
"city": "ASHLAND",
"state": "OR",
"postal_code": "975209120",
"telephone_number": "541-482-2225",
"fax_number": "541-488-2962"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1875 HWY 99 N",
"address_2": "STE 11",
"city": "ASHLAND",
"state": "OR",
"postal_code": "97520",
"telephone_number": "541-482-2225",
"fax_number": "541-488-2962"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MEDECK",
"first_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "DC CCST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-04",
"last_updated": "2015-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OR",
"license": "2147",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "230721",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Ashland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.